Nephrotic syndrome due to membranous nephropathy associated with metastatic prostate cancer: Rapid remission after initial endocrine therapy

A case of severe nephrotic syndrome (urinary protein excretion 12.9 g/day) due to membranous nephropathy associated with untreated prostate cancer and multiple bone metastases is described. A combination of initial endocrine treatment and steroid therapy resulted in normalization of prostate-specifi c antigen levels followed by a rapid decrease of urinary protein excretion within 4 months, No proteinuria was subsequently detected. Seven months aft er the initiation of therapy, the patient remained well with complete clini cal remission from the nephrotic syndrome; This rapid achievement of remiss ion may have been due to tumor shrinkage by androgen ablation in addition t o steroid therapy of the membranous nephropathy. The nephrotic syndrome is a rare complication of pi-estate cancer, and, to the best of our knowledge, no previous cases have been reported of membranous nephropathy as one of t he first disease manifestations. Copyright (C) 2000 S. Karger AG, Basel.